| NPI | 1104174556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 8814) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 1423) |
| 104100000X Social Worker (Licence: OK 6514) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2024-08-06 |